About Me

Tuesday, February 28, 2012

Keeping with my philosophy that healthcare is first and foremost personal and parental/guardian responsibility, not government's, I will post related articles by other authors on how we parents and guardians should take more responsibility in taking care of our kids. I believe that government responsibility in childcare and controlling pediatric diseases is secondary to parental responsibility because the first line of defense towards better health is preventive, not curative. Good nutrition and sanitation, 24/7 watch of babies to prevent injuries, sufficient vaccination, and so on. For children of poorer households, I will grant that there is a role for government, especially in timely vaccination against common pediatric diseases.

Medicine Cabinet -- Reiner W. Gloor

Looking after children’s health

Reduction of infant and child mortality is one of the eight Millennium Development Goals that 189 countries, including the Philippines, committed to achieve by year 2015.

In 2010, these countries recommitted themselves to accelerate development towards achieving the time-bound targets involving health, poverty, education and gender equality, among others.

Significant progress has been made to reach the goal of reducing child mortality by two-thirds in time for the global deadline and the probability of meeting the target is high, according to a report by the National Economic and Development Authority (NEDA).

On the other hand, the United Nations Development Program (UNDP) indicated that global child deaths are falling but not quickly enough.
The UN agency disclosed that nine million children worldwide still die before they reach their fifth birthday.

This signifies that while important milestones have been achieved, efforts must be sustained to meet the goal.

The fight against diseases that affect children has been at the center of biopharmaceutical research and development (R&D).

Treatment advances have yielded new vaccines and medicines that protect children against many fatal childhood diseases, making pharmaceutical R&D for children one of the key contributors in achieving MDGs.

With stakeholders working together to address the unique health needs of children, it is being said that a child born today can expect to live 30 years more than a child born a century ago.

Furthermore, it is estimated that 82 percent of children with cancer will survive five years or even longer compared to 58 percent 30 years ago.

At the moment, the biopharmaceutical sector is developing nearly 300 medicines to help meet the health care needs of children and adolescents.

Already in the pipeline are about 282 medicines that are either in clinical trial or are undergoing regulatory review.

On average, it takes 12 to 15 years from drug discovery to regulatory approval and about $1.2 billion to get one new medicine from the laboratory to patients.

Once a compound reaches the clinical trial stage, it would take an average of six to seven years and another two years for regulatory review.

They include 52 medicines for cancer, 49 for infectious diseases, 48 for genetic disorders and 29 for neurologic diseases.

Furthermore, about 26 are being developed for respiratory disorders, 18 for cardiovascular diseases, 15 for skin disorders and 14 for psychiatric disorders (For the complete list, visit www.phrma.org).

The medicines in development likewise include so-called orphan drugs for rare diseases. Rare diseases are those that affect less than 200,000 people.

For example, researchers are working on medicines for glioma which is a type of brain tumor that can develop in children.

Also on the list are treatments for persistent pulmonary hypertension in newborns and Lennox-Gastaut syndrome which is a severe form of epilepsy that begins before the age of four.

Other candidate orphan drugs are for snake bite, which antivenom is also being developed from snake venom, and black widow spider bite being tested for children 10 years and older.

Some of the medicines in development for children are also placed under “fast track” status to facilitate the development and expedite the review of drugs for serious diseases and fill an unmet medical need.

The regulatory agency assigns the “fast track” status after determination that the drug will have “an impact on the survival, day-to-day functioning, or the likelihood that the disease, if left untreated, will progress from a less severe condition to a more serious one”.

On the other hand, an unmet medical need is defined as providing a therapy where none exists or providing therapy which may be potentially superior to existing therapy.

An example of a medicine in development under this category is for lupus nephritis. The disease is a damaging inflammation of the kidneys that can occur in people with lupus. If not controlled, it may lead to total kidney failure.

Apart from developing new medicines, the Pharmaceutical Research and Manufacturers of America also said that many of the existing medicines are being tested to determine safe and effective dosage levels for children.

The UN Convention on the Rights of the Child spells out the rights of children around the world. One of its core principles is the right to life, survival and development of every child.

Developing new medicines for children reminds us of their right and our obligation to take action.

Medicine Cabinet -- Reiner W. Gloor

Vaccine-preventable diseases in children

Significant progress in reducing under-five mortality is expected to continue beyond the self-imposed deadline of about 189 countries that committed to the United Nations Millennium Development Goals (MDGs) by year 2015.

In its global health situation and trends report, the World Health Organization (WHO) said that under-five mortality will be five million by 2025 compared to 21 million in 1955.

The reduction in the number of under-five mortality can be partly attributed to biopharmaceutical innovation that yielded life-saving medicines and vaccines to diseases afflicting children.

At the moment, there are close to 300 medicines in development specifically for children to address serious diseases and fill unmet medical need.

While progress is being reported concerning the reduction of under-five mortality, WHO estimated that 97% of deaths will occur in the developing world in 2025 and most of them will be due to infectious diseases.

With this, WHO acknowledges the role of immunization against vaccine-preventable diseases.

After all, immunization prevents about 2.5 million deaths every year from diphtheria, tetanus, pertussis and measles alone.

Diphtheria is a disease that may affect people of all ages but often strikes unimmunized children. It is caused by the bacterium, Corynebacterium diphtheria, that could harm or destroy body tissues and organs. It may result in the swelling of the heart muscle, heart failure, coma, paralysis and even death.

Tetanus, on the other hand, is caused by bacterium, Clostridium Tetani, and could lead in serious complications particularly in newborn babies. It may result in broken bones, breathing difficulty and death.

Pertussis (whooping cough) is an important cause of infant death worldwide and continues to be a public health concern. WHO estimates that about 16 million cases of pertussis occurred worldwide, 95% of which were in developing countries, and that about 195,000 children died from the disease.

Early in 2011, the Department of Health (DoH) conducted a door-to-door campaign to immunize Filipino children against measles. Measles is a highly contagious viral disease which could cause encephalitis (brain swelling), pneumonia and death. It remains a premier cause of death among young children globally, despite the availability of a safe and effective vaccine.

WHO also said that more than a million infants and young children die every year from pneumococcal disease and rotavirus diarrhea.

The Centers for Disease Control and Prevention explained that pneumonia is an infection of the lungs that is usually caused by bacteria or viruses. These infectious agents include Streptococcus pneumoniae, the most common cause of bacterial pneumonia; Haemophilus influenzae type b (Hib) -- the second most common cause of bacterial pneumonia in children; and respiratory syncytial virus which is the most common viral cause of pneumonia.

In the Philippines, pneumonia remains the fourth main cause of deaths among Filipinos following non-communicable diseases such as diseases involving the heart, cardiovascular system and malignant neoplasms.

Rotaviruses are the most common cause of severe diarrheal disease and dehydration in young children globally. WHO estimated in 2004 that 527,000 children below five years old die each year from vaccine-preventable rotavirus infections.

Also a major public health concern is the group of viruses (hepatitis A, B, C, D and E) that cause acute and/or chronic infection and inflammation of the liver. Vaccination is one of the strategies used to prevent hepatitis infection. Vaccines exist against hepatitis A and B, while candidate vaccines for hepatitis E prevention exist. Some progress has been shown in developing candidate vaccines against hepatitis C, said WHO.

Meanwhile, Haemophilus influenzae type b (Hib) is a bacteria responsible for severe pneumonia, meningitis and other invasive diseases almost exclusively in children below five years. It could also cause mental retardation and epiglottis, a life-threatening infection that can block the windpipe and lead to serious breathing problems.

Also preventable by vaccine is influenza which is a viral infection that affects mainly the nose, throat, bronchi and, occasionally, lungs. Most infected people recover within one to two weeks without requiring medical treatment. However, in the very young, the elderly, and those with other serious medical conditions, infection can lead to severe complications of the underlying condition, pneumonia and death.

Mumps, on the other hand, is an infection caused by a virus and primarily affects the salivary glands. It most often affects children between five and nine years old. It may lead to complications such as meningitis, encephalitis, inflammation of testicles or ovaries and deafness.

Also, rubella is an acute, usually mild viral disease affecting children and young adults worldwide. Rubella is similarly very serious among pregnant women as it could result in miscarriage, stillbirth, premature delivery and birth defects. (For more information on vaccine-preventable diseases, please go to www.who.int and www.cdc.gov.)

In spite of breakthroughs in science, millions of children still die each year from vaccine-preventable diseases.

Immunization must be taken seriously if we were to achieve MDG 4 on reducing under-five mortality.

Immunization does not only protect children from these fatal diseases, but is also an avenue to deliver other life-saving measures to raise a healthier next generation.